BHARATESH HOMOEOPATHIC MEDICAL COLLEGE &

HOSPITAL
POST GRADUATE RESEARCH CENTRE,
BELGAUM-590016.
KARNATAKA.

Recognized by

CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI.

Affiliated to

RAJIV GANDHI UNIVERSITY OF HEATLH SCIENCES, BANGALORE

SYNOPSIS
M.D (HOMOEOPATHY)

REPERTORIAL STUDY AND CLINICAL PRESENTATION OF

ALLERGIC BRONCHIAL ASTHMA

By

Dr. SUNILKUMAR. K

DR. P.A. CHOWDHARY MD (HOM)

PROFESSOR AND GUIDE,
DEPARTMENT OF REPERTORY, BHARATESH
HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL.
BELGAUM
From:
Dr. SUNILKUMAR.K

To,
DR. P.A. CHOWDHARY MD (HOM)
Professor and guide,
Department of Repertory,
Bharatesh Homoeopathic Medical
College & Hospital. Belgaum.

Sub: Application to accept my synopsis for the dissertation.

Respected Madam,

I Dr. Sunilkumar. K would like to forward my application for the approval of my

synopsis under your guidance of the following topic.

REPERTORIAL STUDY AND CLINICAL PRESENTATION OF ALLERGIC

BRONCHIAL ASTHMA

Hope you will approve the same.

Date: 10-10-2009
Place: Belgaum Yours sincerely,

Dr. Sunilkumar. K

Department of repertory
Bharatesh homoeopathic college &
hospital, Belgaum.
From:
DR. P.A. CHOWDHARY MD (HOM)
professor and guide,
Department of Repertory,
Bharatesh Homoeopathic Medical
College & Hospital. Belgaum.

To:
Dr. SUNILKUMAR. K

Sub: acceptance of synopsis for the dissertation.

Dear Doctor,

I have accepted your topic, REPERTORIAL STUDY AND

CLINICALPRESENTATION OF ALLERGIC BRONCHIAL ASTHMA

For the dissertation.

Your synopsis will be forwarded to RGUHS.

Date: 10-10-2009
Place: Belgaum

DR. P.A. CHOWDHARY MD (HOM)

professor and guide,
Department of Repertory, Bharatesh
Homoeopathic Medical College &
Hospital. Belgaum.
 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE

ANNEXURE II

APPLICATION FOR REGISTRATION OF SUBJECT FOR DESSERTATION

DISSERTATION

1 NAME OF THE CANDIDATE Dr. SUNILKUMAR K

AND ADDRESS
PRESENT ADDRESS:
BHARATESH HOMOEOPATHIC MEDICAL COLLEGE
& HOSPITALS AND RESEARCH CENTRE..
BELGAUM, KARNATAKA -590016

PERMANENT ADDRESS:
S/o. VIRUPAKSHAPPA SAJJAN
PAN MOHALLA,
Po: RANGAN PETH,
Tq: SHORAPUR
Dt: GULBARGA-585220

2 NAME OF THE INSTITUTION BHARATESH HOMOEOPATHIC MEDICAL COLLEGE

& HOSPITALS AND RESEARCH CENTRE..
BELGAUM, KARNATAKA -590016

3 COURSE OF STUDY AND DOCTOR OF MEDICINE

SUBJECT (HOMOEOPATHY) REPERTORY

4 DATE OF ADMISSION 20-03-2009

5 TITLE OF THE TOPIC REPERTORIAL STUDY AND CLINICAL

PRESENTATION OF ALLERGIC BRONCHIAL
ASTHMA
6 BRIEF RESUME OF THE INTENDED WORK:

6.1 NEED FOR THE STUDY :

Allergic Bronchial Asthma is a very common disease with immense

social impact. The prevalence of allergic bronchial asthma is rising in many parts
of the world, In India prevalence of Allergic Bronchial Asthma has been found to
be around 6% in majority of surveys. However, it has been reported to vary from
2 to 17 % in different study populations. This is unclear whether due to actual
increase incidence or merely to the fact that the size of the overall population is
growing. It is estimated that nearly 5 to 10% population suffer from it.

Allergic Bronchial Asthma occurs at all ages but predominantly in early

life. About one-half of cases develop before age 10, and another third occur
before age of 40. In childhood, there is a 2:1 male/female preponderance, but the
sex ratio of equalizes by age 30. It affects all type of socio-economic people,
specially who works at mines, industrys, A.C chambers, stays at over crowding
places etc.

The data collected from the Centers for Disease Control and Prevention
suggest that 10 to 11 million persons had acute attacks in 1998, which resulted in
13.9 million out patients visits, 2 million requests for urgent care, and 4,23,000
hospitalizations, with a total cost >$6 billion. The impact of the disease appears
to fall more heavily on minorities and inner-cities of developing countries.

In such a common clinical condition it is necessary to understand the

fundamental cause, maintaing cause, socio-economic status, susceptibility to
receive and to react the stimuli, the true cause is in the patient himself, so it is
necessary to treat individuals not the disease.

Homoeopathy posses a better scope in treating Allergic Bronchial Asthma,

Homoeopathic treatment became less expensive compare to other system of
medicine and it completely cure the disease, gives better future to the patient. So I
would like to study this topic.
6.2 REVIEW OF THE LITERATURE :

The word Asthma is derived from Greek " " and signifies
panting or to breath with open mouth. 1
The word Allergy is derived from Greek language, Allos means other
and Ergon means work i.e altered work.

Allergic Bronchial Asthma is defined as a chronic inflammatory disease of

airways that is characterized by increased responsiveness of the
tracheobronchial tree to multiplicity of stimuli, Followed by rise in IgE
antibodies when they come in contact with allergens. It is manifested
physiologically by a widespread narrowing of the air passages, which may be
relieved spontaneously or a result of therapy, and clinically by a paroxysms
of dyspnea, cough, and wheezing. 2

Traditionally asthma is divided into two types: Atopic and Nonatopic

ATOPIC ASTHMA: Patient with atopic asthma form IgE antibodies when they
come in contact with common allergens. Atopic asthma usually starts at an
early age and is provoked by allergens in addition to other triggers. Atopic
individuals usually have allergic ailments of skin, nose and eyes. In their
families, allergic diseases are more common. Skin tests to common allergens
are positive and serum IgE levels are increased. Atopic asthma is also called
extrinsic or early onset asthma.
NONATOPIC ASTHMA: This is usually provoked by allergens. In patients
with nonatopic asthma family history of allergic diseases is uncommon. It
starts in adult age. Skin tests to allergens are usually negative. It is also
called intrinsic or late onset asthma. 3

Inducers and triggers of Allergic Bronchial Asthma

INDUCERS: After birth, several factors interest to result in the clinical
manifestations of asthma. Factors called inducers actually switch on the
asthma following which symptoms may be present for weeks, months or
years.
 1. Infections
2. Cigarette smoke
3. Allergens
(a) Aero allergens: Dust, mite allergens, tree pollens, feathers, paint,
smoke, animal dander, moulds.
(b) Ingestants Milk, eggs, nuts, chocolates, fish, shell-fish,
strawberries etc.

TRIGGERS :
1. Night or early morning
2. Exercise (especially running)
3. Cold air, fog
4. Viral respiratory tract infection
5. Allergens (e.g. house dust, mite, cat fur) 4

Asthma is not a uniform disease but a dynamic clinical

syndrome with a variety of features. Typical symptoms include recurrent
episodes wheezing, chest tightness, breathlessness and cough. Common
precipitants include exercise, particularly in cold weather, exposure to
airborne allergens or pollutants, and viral upper respiratory tract infections
(beware the cold that goes to the chest or takes more than 10 days to
clear).

Asthma being worse in the early morning. Particularly when asthma is

poorly controlled, symptoms such as cough and wheeze disturb sleep and
have led to the use of the term nocturnal asthma. Cough may be the
dominant symptom in some patients and the lack of wheeze or
breathlessness may lead to a delay in reaching the diagnosis of so-called
cough-variant asthma. 5
 Some Rubrics found in KENT repertory are
Section: Cough
Rubric: Asthmatic, Page No:782
Rubric: Night, Page No:780
Sub Rubric: Waking from the cough, Mid night, Page No:780 & 781 6

Some Rubrics found in BBCR are

Section: Respiration
Rubric: Asthma
Sub Rubric: Attack during, bronchial, Page No: 690
Sub Rubric: Panting, gasping, Page No: 693
Section: Cough
Rubric: Asthmatic Wheeze, Page No: 705 7

Some Rubrics found in CLARKE CLINICAL REPERTORY are

Section: Clinical
Rubric: Asthma
Sub Rubric: Anger from, bronchial, dry, humid, Page No:39 8

Asthma has inconvenient red flag that precedes it in many pediatric cases
Atopic Dermatitis. Approximately half of the babies diagnosed with
atopic dermatitis go on to develop asthma. This tendency can be
described as an allergic cascade over the immune system, Allergies,
Asthma, Atopic dermatitis, Anaphylaxis, Allergic rhinitis and Acid reflux.
9
Research has definitely shown a correlation.

Allergic Bronchial Asthma is a chronic, dynamic disease. It needs

administration of remedy as the guidelines prescribed by Dr.Hahnemann
to treat the chronic diseases. Since the Allergic Bronchial asthma shows
the genetic trait it falls mostly on Sycotic miasm having psoric
expressions as acute exacerbations like wheeze, sneeze the itching. Some
mixed miasmatic expression also seen in little cases.
 Psora: Hypersensitivity of the tracheobronchial tree to any allergen
indicates psora as the basic cause.
Sycosis: History of Bronchial asthma in the family, both paternal and
maternal side is suggestive of hereditary sycosis as the basic cause.
Syco-Syphilis: History of syphilitic miasmatic state in the family with
symptoms of latent syphilis and developed sycosis in the patient
suggestive of syco-syphilis.
Mixed miasmatic state: In some cases a combination of all the above
mentioned factors may be present making the state much more
10
complicated and difficult to diagnose and also to treat.

Physicians typically diagnose asthma by looking for the classic

symptoms: episodic problems with breathing that include wheezing,
coughing, and shortness of breath. When symptoms alone fail to establish
a diagnosis of asthma, doctors may use spirometry, a test that measures
airflow. By comparing a patients normal airflow, airflow during an attack,
and airflow after the application of asthma medication, doctors determine
whether the medicine improves the patients breathing problems. If
asthma medication helps, doctors usually diagnose the condition as
asthma. 11
The truth is that both the parents and the doctor are helpless. The only
saving grace is the inhaler on which the patient is put forcibly to avoid the
attack and wait patiently until the child grows out of it. The parents who
are dejected need to be here reassured, that allergy and asthma is
completely curable if treated with correct homoeopathy. 12

6.3 OBJECTIVES OF THE STUDY:

1. To study the clinical presentation of Allergic Bronchial Asthma.
2. To study the management of Allergic Bronchial Asthma through holistic
approach.
3. To individualise the case of Allergic Bronchial Asthma.
4. To prevent the complications of Allergic Bronchial Asthma.
5. Counseling and Advice to change the life style.
 MATERIAL AND METHODS:
7.1 SOURCE OF DATA:
7
The subject for the study will be taken from the OPD / IPD village health
camps of Bharatesh homoeopathic medical college and hospital, Belgaum.

7.2 METHOD OF COLLECTION OF DATA : (including sampling

procedure if any)
Inclusion criteria:
Patients of Age group 1 to 40, of both sex.
All diagnosed cases of Allergic Bronchial Asthma.
All type of socio-economic status patients.

Exclusion criteria:
Patients of Age group above 40.
Allergic Bronchial Asthma complicated with other systemic disorders.

Result criteria:
Partially improved
Improved
Not improved

Patients will be selected on the basis of inclusion and exclusion criteria,

history, clinical finding. Detailed case history by interview as per the
proforma prepared for the topic will be taken. On the basis of homeopathic
totality, treatment will be started.

Sample size will be minimum 30 in number. No particular sampling

procedure shall be adopted.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

 INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER
HUMANS OR ANIMALS? IF SO, PLEASE MENTION BRIEFLY.
YES, the study requires following investigation.
Blood examination:
CBC
ESR
AEC
Special investigations: (As an when it is required)
Sputum examination.
X-ray chest.
IgE

7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR

INSTITUTION IN CASE OF 7.3
Yes, ethical clearance has been obtained from the institution.

LIST OF REFERENCES:

1. Mills. PRACTICE OF MEDICINE, New Delhi, Re-print Edition 1989,

8.
B.Jain Publishers (P) Ltd. 362 pp.

2. Dennis L.Kasper, HARRISONS PRINCIPLES OF INTERNAL

MEDICINE, Vol:2, USA,16th Edition, McGraw Hill Inc., Copyright 2005,
1508pp.

3. Siddharth N.Shahs API TEXTBOOK OF MEDICINE, Mumbai, 7th

Edition Revised Reprint, publisher The Association of Physician of India,
2006, 291pp.

4. Golwallas MEDICINE FOR STUDENTS, Mumbai, 22nd Edition,

 published by Dr.Aspi F.Golwalla. 114pp.

5. Davidson Stanelys DAVIDSONS PRINCIPLES & PRACTICE OF

MEDICINE, Edinburgh (UK), 20th Edition Reprint, Churchill Linvingston
Publishers, 2006. 671pp.

6. Dr.J.T.Kent. REPERTORY OF THE HOMOEOPATHIC MATERIA

MEDICA, New Delhi, 6th American Edition Reprint, B-Jain Publishers,
2006, 2007. 780 & 781pp.

7. Dr.C.M.Boger BOENNIGHAUSENS CHARACTERISTICS MATERIA

MEDICA AND REPERTORY, New Delhi, Reprint Edition, B-Jain
Publishers 1998. 705pp.

8. J.H.Clarke. A CLINICAL REPERTORY TO THE DICTIONARY OF

MATERIA MEDICA, New Delhi, Reprint Edition, B-Jain Publishers
1987. 39pp.

9. Dr.Beena Thomas, Bronchial asthma & its homoeopathic management,

CONTINUED MEDICAL INFORMATION (CMI), Vol, 2 no,ii, 2009.
11pp

10. Dr.Tapan kumar pradhan. Miasmatic Expression in Bronchial Asthma,

SIMILIUMUM IN BRONCHIAL ASTHMA, HOMEO TIMES, 2009,
20pp.

11. www.homeoint.org. assessed on 03/10/2009.

12. www.cureasthma.co.in assessed on 05/10/2009

9 SIGNATURE OF CANDIDATE

10 REMARK OF GUIDE

11. NAME AND DESIGNATION OF DR. P.A. CHOWDHARY MD (HOM)

PROFESSOR AND GUIDE,
11.1 GUIDE DEPARTMENT OF REPERTORY,
BHARATESH
HOMOEOPATHIC MEDICAL
COLLEGE AND HOSPITAL.
BELGAUM

11.2 SIGNATURE

11.3 CO-GUIDE
(If any)

11.4 SIGNATURE

11.5 HEAD OF THE DEPARTEMNT Dr. D.H. AJGAONKAR MD (HOM)

PROFESSOR, GUIDE AND HOD,
DEPARTMENT OF REPERTORY,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE AND
HOSPITAL. BELGAUM

11.6 SIGNATURE

12.1 REMARKS OF THE

CHAIRMAN &
PRINCIPAL

12.2 SIGNATURE